ALL patients are seen at our Portsmouth office on Saturday and Sunday for sick visits from 9-12 am

Offices:

Hampton

603.929.3838

55 High Street
Hampton, NH 03842

Portsmouth

603.436.7171

330 Borthwick Avenue Portsmouth, NH 03801

Well Child Visits

The 6 Month Visit

Development:
This is a busy age for infants. Many don’t like to sit still, even to have their diapers changed or to sleep. It is a time of great exploration of everything within reach- first with their hands, then with their mouth. They are fascinated by their hands and anything in them, which they quickly bring to their mouth- they even get their feet into their mouth! Chewing leads to biting, and particularly breast feeding mothers may need to repeatedly remind the baby that people are not meant to be bitten. They may also pull at their ears. This does not necessarily indicate an ear infection. As they explore their bodies, they invariably find and handle their genitals. This is normal and is best ignored by adults.

This age has been termed the “spoiling age”. Your baby has simply become wise enough to have very strong opinions of his own. Babies, who previously went down well at night, may now fuss when put down. Perhaps for the first time, both parents will now have to “get together” and set certain policies for the baby’s general guidance and management policies that may require firmness, decisiveness and consistency.

Your baby is still probably a little wobbly when sitting, but will soon sit well alone. He is reaching with one hand and transfers objects from hand to hand. He will rake at small objects with his fingers, but probably still can’t pick them up easily. He may hitch along the ground on his stomach, and is now able to change the orientation of his entire body in order to extend a hand toward a desired object. He may be supporting his weight on his legs when pulled to standing. Don’t worry; this will not cause bowing of the legs. He is becoming a real socialite! He knows his parents, his cup, his bottle and other familiar objects. He recognizes strangers, but probably is not yet afraid to be around them. He may be making Dada or Mama sounds and will respond to changes in your facial expression. He will enjoy little games of peek-a-boo with you. He looks to you for security, and may cry when left alone.

Praise language attempts, but do not over-emphasize. Indicate outdoor objects in motion, i.e. trucks, cars, birds and airplanes. Tickling and touching games are fun. Your child will enjoy textured and patterned objects to handle. Alternate toy selection. Divide toys into groups and change groups frequently. Your baby will also enjoy mirror play. To encourage gross motor skills, roll your child back and forth on a beach ball; support him while he sits, and introduce water play.

Feeding:
If you haven’t yet started, now is the time to introduce solids. Start with the baby cereals- usually rice first, I or 2 tablespoons once a day (as tolerated; you can increase to twice daily)- then oatmeal and barley. Next vegetables or fruits. Introduce vegetables by beginning with the yellow ones. Meats are the least important at this age, and should be added last at around 7-8 months. Minced meat and vegetable dishes are mostly vegetable and probably not worth buying. Go slowly with solids. Don’t add more than one new one a week, so if the baby develops an intolerance you will know which food is the offender. Feeding can be a challenge to your patience and dexterity at this age as babies feel they should help you. They do this by grabbing the spoon, squeezing the food through their fingers and blowing bubbles with their mouth full. It helps if you can keep your sense of humor. Also, you might give the baby something to hold in each hand, like crackers or teething biscuits. Eventually, you should be able to get the baby on 3 meals and 3 or 4 bottles or nursings per day. A night bottle should no longer be necessary, though it may take some persistence to break your baby of that habit.

You might start to introduce the baby to a training cup. Offer water or formula in the cup. Once things are going well with baby foods, you can be innovative. Soft table foods, such as mashed potatoes and squash, can be tried. The baby may enjoy feeding himself small pieces of banana, dry toast or teething biscuits. As he gets older, with careful chopping or a blender, you can get along without buying junior foods”. Fruit can be given as a dessert. The baby doesn’t need extra sweets, and you should avoid giving the baby “empty” sweet drinks like soda, Koolaid or juice. Do not let the baby have a bottle of milk in bed at naptime. It causes cavities and may contribute to car infections. Just give the baby plain water at these times. Avoid eggs, fish, peanut butter, cow’s milk and honey until your child is I year of age. Remember, feeding time should be an enjoyable experience for both child and parent.
 
As your baby matures, bowel movements may become more formed and may be less often. The consistency and color may vary with the variety of foods.

Common Concerns.
Teething discomfort may be eased by rubbing the gums with a clean finger or ice in a cloth, using refrigerated teething rings or cold popsicles. Tylenol (acetaminophen) may help. A medicine called Oragel, available at pharmacies, may also be used. This is the time to provide Fluoride for dental protection if your water is not fluoridated.

Most normal children have 2-8 colds a year. When you consider most of them happen during 6 months out of the year, it does sometimes seem like the baby has “one cold after another”. Colds are viruses infecting the upper respiratory tract. Cold symptoms consist of sneezing, Watery eyes, sore throat, dry cough, a stuffy nose with a clear watery discharge from it, poor appetite, a low grade fever of 100-101 degrees and frequently fussiness and tiredness. Most symptoms last 7-14 days. There is no cure for a cold, but there are several things you can do to make your child more comfortable, such as: a) offer extra liquids, b) use a cool mist humidifier, c) use a nose syringe to clear mucous from the nose- make a saline solution (1/2 teaspoon salt in 8 ounces of water) and put 2 drops in each nostril and then suction to clear, d) Tylenol (acetaminophen) every 4 hours for fever. The cool air vaporizer is preferable, mainly for safety reasons.

Call our office if your child:
• complains of a sore throat
• complains of an earache or is excessively irritable
• stops drinking fluids
• persistently vomits or has diarrhea
• seems extra sleepy or does not act like his usual self
• has an excessively high fever over 103 degrees

Immunization:
Today your child will receive immunization as recommended by the American Academy of  Pediatrics and the Center for Disease Control. If he has had any previous problems with immunizations or if you have questions, please ask us.

 

                                                                                                   adapted from John Chamberlain
                                                                                                                  Rose Boynton, etal.
                                                                                                                         Barton Schmidt